What is an ovarian tumour?
A tumour is an abnormal mass of tissue. Like a cyst, a tumour can develop in any part of the body, but unlike a cyst that is fluid-filled, a tumour is a solid mass of cells. Tumours can be benign (non-cancerous, do not spread to other parts of the body or malignant (cancerous, spread beyond its site of origin).
The ovaries are part of the female reproductive system that produces eggs and the female hormones, oestrogen and progesterone. Many types of tumours can start to grow in the ovaries – some are benign and never spread beyond the ovary, while others are malignant or cancerous. However, it is important to know that not all ovarian tumours turn cancerous.
Ovarian tumours are named after the cells they develop from, and this is regardless of whether the tumour is benign or cancerous. There are three main types of ovarian tumours:
- Epithelial tumours: which start from the cells covering the outer surface of the ovary.
- Germ cell tumours: which start from the cells that produce the eggs.
- Stromal tumours: which originate from the cells that hold the ovary together.
What are the causes of ovarian tumours?
The causes of ovarian tumours are not well understood so far. However, there are certain risk factors that may make you prone towards developing an ovarian tumour.
- Age (women near menopause)
- Women without children or not breastfeeding
- Fertility drugs
- Hormone replacement therapy
- Genetic disposition or family history of ovarian, breast or colorectal cancer
What you need to know about symptoms or signs?
Some tumours may not show any symptoms and go undetected until a regular pelvic exam with your doctor. Symptoms of an ovarian tumour may include:
- Pain, bloating or feeling of pressure in the abdomen
- Difficulty while urinating; frequent urination
- Painful menstruation, abnormal bleeding
- Painful sexual intercourse
- Swelling in legs or area around vagina
- Weight gain
- Loss of appetite; feeling full quickly
Which specialist should you consult if you have any of the signs and symptoms?
Schedule an appointment with your gynaecologist if you are experiencing some or all the symptoms listed above.
What are the screening tests and investigations done to confirm or rule out ovarian tumour?
Your gynaecologist may find an ovarian tumour while doing a pelvic exam and will most likely ask you to undergo the following tests:
- Ultrasound scan, CT scan or MRI
- Blood tests to check levels of hormones like luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol, and testosterone.
- Laparoscopy, a surgical procedure that uses a light-guided device to be inserted into your abdomen. S/he may also remove a small piece of tissue to test if the tumour has become cancerous or not.
What treatment modalities are available for management of ovarian tumour?
Surgery to remove the tumour from the ovary or the complete ovary is the usual mode of treatment. Laparoscopic surgery for benign ovarian tumours involves a small incision in the lower abdomen (below the navel) through which a light-viewing instrument is inserted. Other small incisions in the abdomen wall allow for instruments to be inserted and the tumour to be removed.
Depending on the location and size of the tumour, your doctor may opt for a laparotomy, which is similar to laparoscopy but requires a larger incision. The removed tumour is also checked for any cancerous indications.
Immediate surgery is conducted in cases when the ovary becomes twisted with the tumour. You would be experiencing severe abdominal pain, nausea and vomiting in such a case.
What are the known complications in management of the disorder?
Though laparoscopy is a minimally invasive surgical procedure, but like in the case of any surgery, the following complications may occur:
- Bleeding from incisions
- Damage to a blood vessel or nearby organ. This would require a separate surgery for repair
What precautions or steps are necessary to stay healthy and happy during the treatment?
Talk to your doctor about any medication that you are taking, and whether you need to change your usual medication routine in the days before surgery. Avoid strenuous actions like driving, lifting weights or exercise for a week after the surgery. Your doctor may advise you to refrain from sexual activity or use of tampons till you recover. Wait for three months before attempting to conceive a baby to allow the tissues to heal.
Is there any risk to other family members of having the disorder?
A strong risk factor for ovarian tumour is a family history of breast or ovarian cancer. A hereditary form of colorectal cancer can also put you or your family member at risk for ovarian tumour. Discuss your family history with your doctor, including medical history of women on both sides (father’s and mother’s) to chart out preventive strategies.
How can you prevent the disorder from happening or recurring?
There is no defined way to prevent the occurrence of benign ovarian tumours. However, undergo routine physical check-ups like the pelvic exam and the Pap test as recommended by your healthcare provider. This will help your doctor to identify and diagnose any changes in the ovaries as early as possible.